Individual provider Active NPI

Samuel Hargrove

  • Marriage & Family Therapist
  • Evansville, IN
National Provider Identifier
1962993865
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35000876A Issued in IN
Practice address
1133 Lincoln Ave
Evansville, IN 47714
Phone
(812) 491-2615
Fax
(812) 471-6650
NPI assigned
May 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Marriage & Family Therapist 106H00000X 35000876A IN Primary

Addresses

Primary practice location

1133 Lincoln Ave
Evansville, IN 47714

Mailing address

PO Box 1165
Evansville, IN 47706-1165
Phone (812) 471-1591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35000876AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maglinger Home Based Services Inc. Past Accepting new patients
Indiana Eye Center LLC Past Accepting new patients
Counseling for Change, Inc. PastSince Jun 1, 2018 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1962993865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1165",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061165",
            "telephone_number": "812-471-1591",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 LINCOLN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-491-2615",
            "fax_number": "812-471-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000876A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.